Hospitals need to adapt and change

The head of the health service has warned that some hospitals would face a difficult future.

NHS chief executive Sir David Nicholson has also said that private sector take-overs, mergers and more community-based care may be needed to ensure all hospitals survive the shake-up of the NHS.

While not expecting any hospitals in England to close, Sir David said that reforms and financial pressures would mean many having to adapt and change to remain competitive.

Sir David, who will become the chief executive of the NHS commissioning board when GP consortia are set up as part of the government’s plans for the NHS, said that with annual budget rises of 0.1% above inflation the NHS faces a demanding period.

Sir David said: “Most hospitals will be able to survive and thrive in the new world. But undoubtedly there will be those that will find it difficult.

“The thing about the hospital service is that it has grown enormously over the last 10 years in particular and we are going into a period where growth in the NHS is what they describe as 'flat real'.”

Hospitals with a business model based on increasing capacity may have to rethink their approach, he said.

That could involve more taking over community services, others merging with neighbouring hospitals or some services being scaled back.

While the NHS Confederation feared some hospitals may shut, Sir David said he did not expect this would happen.

The British Medical Association also agreed that hospitals were facing a challenging future.